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Flashcards in Post Deck (57):
0

What are the indications for a post crown?

Insufficient coronal dentine remains to support a conventional style prep for a crown

1

What is the purpose of the post?

This provides retention

2

What is the pyrosis of the core?

This replaces the lost dentine to provide diffidence height and parallelism for crown retention

3

When are post crowns indicated?

Mainly anterior teeth
Post root treatment
Insufficient tooth structure or enable crown prep
Augmentation of retention is required

4

What are the type of post core systems?

Direct vs indirect
Prefabricated vs custom made
Smooth vs patterned
Metal vs composite fibre
Active vs passive
Conventional mechanical engineering strength principles vs biomimetic principles

5

Which out of parallel or tapered posts are more tentative?

Parallel posts

6

Which is the disadvantage with parallel posts?

Prep can result in perforation

7

What are the advances and disadvantages of tapered posts?

Less Risk of perforation during preparation

But can exert a wedge effect on the tooth which could split the root

8

How can we modify the surface texture?

Threaded: most retentive
Serrated: most commonly used
Smooth : less retentive

9

Name an example of a threaded post and what are the advantages and disadvantages?

Radix anchor and dentatus screws
AD: offer greatest retention
Dis: threads lead to stresses and increase likelihood of root fracture, they are wife posts which wedge the root apart.

10

Which type of posts cause the most stress and Increaed risk of failure?

Tapered and threaded posts

11

Which type of post surface do we usually use?

Serrated
This enables the cement to interlock

12

Why do we make separate posts and cores for the crown?

To aid retrievability
And enable ferrule effect where sufficient coronal dentine

13

What do we need to consider when placing a post crown?

PROVE
Perio: perio disease and plaque control
Restorative ability: condition of remaining teeth, caries, how much remaining tooth structure
Occlusion: tilting or over eruption of adjacent teeth into space, presence of wear facets, evidence of para function, guidance of tooth in protrusion or lateral excursions
Endo: outcome of endo treatment?

14

What special investigations would you need for a post crown?

Signs and symptoms
Full chart
Periapical
Radiographs
Articulated study models

15

What are the absolute contradictions ?

Severe perio
Vertical root fracture
Short roots

16

What are some salvageable contraindications to a post?

Caries: restore first
Perio: stabilise first
Subginginval margin: consider crown lengthening
Insufficient space for final restoration: create space
Previous perforation: repair

17

Which things would be considered as pushing the boundaries with regards to post?

Insufficient coronal structure for a ferrule
Using the tooth as an abutment for a fixed or removalble prosthesis
Bruxism

18

What is a ferrule??

Circumferential supragingival core of metal to prevent the root from splitting

19

Where should the crown margin be placed ?

2mm apical to core margin

20

What are the ideal post and core dimensions?

At least 4.5mm GP
At least 1mm dentine
Post: crown ratio at least 1:1 ideally 1.5:1
From crown margin to top of ferrule should be 3.5mm

21

What could you consider doing before you take your impression?

Consider applying glass ionomer or zinc oxide cement to seal GP but not if using composite

22

Which cement should we use to cement the post im?

Zinc phosphate

23

What kind of seating action should you use to cement the post?

A pulsing action

24

What is the disadvantage of using zinc Polycarboxylate?

Low compressive strength

25

What is the disadvantage of using GIC?

Propogation of cracks

26

What is the disadvantage if using resin?

Lack of retrievable

27

Where are voids most significant and least?

Least: mid third
Most: apical or coronal

28

What material could you use as a core?

Metal: NiTi: core is made in lab
Composite: for fibre composite system
GIC not strong enough

29

What are the two broad choices for post and core?

Customised metal post and core
Fibre post and core

30

What are the advantages and dis of a metal post and core?

AD: tried and tested with good results when used appropriately , crown to root angle can be adjusted, strong even in think section, removal possible

Dis: post and root can fracture, can be difficult to remove, Appearnce of metal through tooth, possible corrosion, staining of dentine, rigidity greater than dentine, possible leakage of temp post crown, susceptible to impression error

31

What are the advantages and disadvantages of a fibre composite post and core?

AD: reduced number of visits, no temporary postcore, metal free, god light transmission, adhesive technology, potentially biomimetic, maybe possible to use shorter posts due to bonding, bind possible strengthens tooth, less likely to fail due to root fracture

Dis: adhesive technology sensitive and bond weak link

32

What are the post factors that will affect the longevity of the tooth?

Type of post
Design of post
Cement
Presence of ferrule
amount of remaining coronal and root structure
Endo quality,
Occlusal forces
Bruxism
Tooth used as an abutment

33

How do posts fail?

EARLSS
Endo: inadequate endo, host healing vs virulence of pathogen, leakage due to poorly fitted post, poor temporary
Aesthetics
Root fracture: post too short, post too long, post too narrow,active, tapered, post not following anatomy, inadequate dentine, no ferrule
Loss of Retention: post too short, post and core poor fit, weak cement and wrong method of cementation, difficult to bond to root dentine, traumatic occlusion
Separation: casting porosity at narrowest point between post and core, post too narrow and high stress applied, lab casting errors

34

How do you remove metal posts?

1. Ultrasonic peezo scaler to loosen cement
2. Trephine from masseran kit rotated anticlockwise to cut a channel around post to 50% of its length and remove with smaller trephine

35

How do you remove fibre posts?

Reciproc system
Other rotary
Peezo reamers

36

What are the 7 stages to post prep?

1. Removal of GP
2. Coronal prep
3. Post space preparation and antirotatjon
4. Achieve ferrule
5. Impression
6. Temp crown
7. Cement post and core. Cement crown. Separate entities for retrievable

37

How much GP should you remove?

1. Length of post must be at least the same height as crown
2. Leave at least 4mm GP
3. Extend to beyond centroid
4. 2/3 of root length
5. Long as possible with 1mm dentine around

38

What must the tip of post be supported by and why?

The root structure to prevent a crow bar effect

39

How do you remove GP?

Select gates glidden bur and set to correct length and remove GP

40

What should the coronal prep be like?

Needs to be like a conventional prep with a labial shoulder which is placed in the gingival crevice and the Palatal shoulder is placed at the margin. Needs to be at least 1mm dentine around the post space to avoid fracture in function and on die material in the lab

41

What must be incorporated in the post space prep?

Antirotation

42

What are the components of the para post kit?

Drill
Smooth impression post
Serrated burn out post
Aluminium temporary post

43

What type of system is the para post kit?

A hybrid contains both prefabricated and custom made components

44

What are the prefabricated components of the para post kit?

Use drills to prepare the canals and use a plastic burn out post to fit post space

45

What are the custom made components of the para post kit?

Core made in eitherwax or duraly invested in type 4 gold alloy

46

What effect does the ferrule effect have in the impression?

Makes recording the impression easier

47

Which impression technics are there?

Indirect impression with oppsing alginate.
Direct with duraly impressioon

48

How does the indirect impression technique work?

One end of the smooth impression post is flattened outside th mouth to aid retention in impression material the upper part of the impression post and head are coated in adhesive

49

How does the direct impression with the duraly work?

Serrated plastic burnout post inserted into space and then coat dentine with a separting medium
Duraly then shaped and once polymerised is finished with instruments eg disk .
Duraly and burnout post come off in one piece and cause in type 4 gold

50

For both the direct and the indirect impression technique, what must you place in the post space to temporise it?

The aluminium post which has been scored diagonally to provide Antirotation

51

How much must the aluminium post protrude from the tooth?

2mm

52

How do you temporise the crown?

Using a directa crown and trim

53

How do you remove the GP for the composite fibre post?

Using peeso reamers which act like GG

54

How much fibre post should be protruding from the tooth?

2mm

55

What must you do to the post before cementing properly ?

Must decontaminate in alcohol

56

What is the bonding procedure for the composite fibre post?

1. Etch tooth with 37% phosphoric acid and use a K file for this
2. Wash
3. Dry the canal with paper points
4. Place bond in canal and self cure activator his will chemically cure inside the canal
5. Apply bond to post and light cure
6. Use calibra past and catalyst and mix them. Then place into canal and post and then light cure for 10 seconds.
7. Remove excess and then fully cure.
8. Build up composite